title: Association between age and severity to leptospirosis in children.
abstract: BACKGROUND
  In endemic areas, leptospirosis is more common and more severe in adults compared with children. Reasons to explain this discrepancy remain unclear and limited data focusing on adolescents are available. The objective of the study was to describe disease spectrum and outcome differences in children and adolescents admitted for leptospirosis in a large at-risk population.
  
  
  METHODS
  Clinical and laboratory data were obtained on hospitalized cases in New Caledonia from 2006 to 2012.
  
  
  RESULTS
  Data of 60 patients <18 years of age (25 children under 14 and 35 adolescents aged 14 to 17) with confirmed leptospirosis were analyzed. Compared with children, adolescents presented more often with classic features of Weil disease (p = 0.02), combining hepatic and renal involvement with or without pulmonary participation. Jarisch-Herxheimer reactions were observed more often among adolescents (p<0.01). The overall case fatality rate was low (1 adolescent versus 0 children).
  
  
  CONCLUSIONS
  Severe leptospirosis in adolescents may be more likely to show adults' characteristics compared with children. Further studies are required to explore age-dependant host factors, including puberty-related physiological changes.
authors.affiliation: Intensive Care Unit, Centre Hospitalier Territorial, Noumea, New Caledonia.
authors.forename: Gilles
authors.initials: G
authors.lastname: Guerrier
authors.forename: Pauline
authors.initials: P
authors.lastname: Hie
authors.forename: Ann-Claire
authors.initials: AC
authors.lastname: Gourinat
authors.forename: Emilie
authors.initials: E
authors.lastname: Huguon
authors.forename: Yann
authors.initials: Y
authors.lastname: Polfrit
authors.forename: Cyrille
authors.initials: C
authors.lastname: Goarant
authors.forename: Eric
authors.initials: E
authors.lastname: D'Ortenzio
authors.forename: Isabelle
authors.initials: I
authors.lastname: Missotte
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D006761:Hospitals; D006801:Humans; D007922:Leptospirosis / Q000401:mortality / Q000473:pathology*; D008297:Male; D009510:New Caledonia; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis